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Describe Dobutamine drug
- 1.Positive inotrope
- 2.increases cardiac output w/o increasing O2 demand of the heart
- 3. Helps contractility
- 4. diuretic-vasodilator
Describe Nitropusside (Nipride)
- 1. Dilates veins & arteries
- 2. Decreases cardiac workload
- 3. Decreases preload & afterload
- 4. Decrease systemic, hypertension →
- hypotension ↓ cardiac output
5. light sensitive
Treatments for CHF
Diuresis or improve contractility
The drug that gets rid of extra fluid
diuretic drug...Furosemide (Lasix)
The drug that decreases angiotensin II and aldesterone and has a dry non-productive cough as a side effect
The drug that slows the heart allowing more time for the heart to fill
The drug that decreases both preload and afterload by vasodialtion
The vessels known as the capitance vessels and regulate preload
An endogenous substance and is a potent vasocontrictor
The preferred treatment for hypertension
Life style change
The blood pressure =
CO x TPR
TPR= Total peripheral resistance across systemic circulation
Na channel blocker
Prevents depolarization and ↓ excitability and contraction outside the SA node
- Class II drug
- ↓ HR, Conduction, BP and O2 consumption of the heart
- ↑ filling time better contractility & force output
Describe Amiodarone drug
Prolongs re-polarization but has serious side effects of pulmonary fibrosis
Arrhythmia that originates above the ventricles and include afib & aflutter
What is the normal electrical pathway of the heart?
SA node → AV node → Bundle of HIS → Bundle branches → perkinjie fibers
Aspirin used for
A cardiac drug for its anti-platelet aggregation properties
Heparin is used for
Anti-coagulant that can only be given via injection
Warfarin is used for
Anti-coagulant that inhibits vitamin K and is given orally
Streptokinase or Urokinase is?
Thrombolytic is injected directly into the coronary arteries to dissolve a clot and managment of AMI
- 1. Drug used to make the heart more susceptible to shocks.
- 2. Improves the likelihood of converting ventricular fibrillation and tachycardia to rhythms with spontaneous circulation.
- 3. Improves cerebral blood flow.
- 4. Increase rate and force.
- Keeps the heart rate stable
- Does not increase the HR and prevents it from decreasing
Sodium bicarb given when?
Only given in a code when the patient has metabolic acidosis, hyperkalemia or DO
Blood flow through the heart:
Rt Atrium → Rt Ventricle →Pulm artery→Pulm Vein→Lft Atrium→Lft Ventricle
- -The process of potassium moving out of the cell and sodium moving in → causes contraction.
- -Resting: Potassium moves back in sodium moves out.
- -Calcium needed for muscle contaction
Decreasing peep at 2cm intervals until there is a decline in O2 delivery.
Positive pressure ventilation =
- ↓ CO because of alveolar pressures ↑ intrathoracic pressure ↓ venous return. ↑ Alveolar pressure stretches and narrows the capillaries that surround the alveoli =
- ↑ PVR →overdistention of the rt ventricle (backs up) cor pulmonade ↓ Lft ventricle output
Narrowing of the lumen of the trachea
Softening of the tracheal rings that collapse upon inspiration.
Humidification temperature should be
32-35 degrees Celsius
9-14 mEq/L normal value
+14 fixed acid problem
Pulmonary Capillary O2 content equation
CcO2=(Hgx1.34) + (PAO2x0.003)
Carrying of blood to the tissues in the pulmonary arteries equation
- (Hgx1.34xSaO2) + (PaO2x0.003) = CaO2
- Hg + Plasma
Normal value 16-20ml/dl
Cause of ventilatory failure
- Perfusion in excess of ventilation, wasted perfusion, atelectasis
- Causes refractory hypoxemia: Healthy <5%
- Non critical <10% Critical >30%
- 10-20% Mild, 20-30% sig. shunt
Diffusion A-a gradient
RAW normal airway resistance
0.6-2.4cmH2O/L/Sec @ a flow rate of 30L/min
In mechanical ventilation RAW is primarily affected by the length, size and patency of the airway, endotracheal tube, and ventilator circuit
- 80-100 mmHg Normal
- 60-79 mmHg Mild
- 40-59 mmHg Moderate
- less than 40 mmHg Severe
- Cause of ventilatory failure
- Reduction of alveolar ventilation ↑ PaCO2
- PaCO2 >45mmHg
- >50mmHg COPD pt.
Venous Blood Gases
- 7.30-7.40 pH
- 42-48 PaCO2
- 24-30 HCO3
- 35-40 VO2
- Loss of contractility or pump efficiency ma the blood volume increase within the heart.
- ↓ Efficiency ↑ Afterload pumps against resistance can't empty
- ↑ Volume hypertrophy CO↓ blood flow to kidneys ↓ dehydrated, hypovolemic kidneys retain fluid - backs up t/o body